An 8 year old child got trauma and got his central incisor avulsed 20 minutes back which got contaminated with debris. The child rushes to dental clinic with avulsed tooth, the treatment is:
Correct Answer: Clean root surface with saline and reimplant
Description: If the tooth has been out for 15 minutes to 60 minutes:
Tooth with closed apex
Clean the root surface with saline.
Do not touch a viable root with hands, forceps, gauze or anything, or try to scrub or clean it to avoid injury to
the periodontal ligament which makes it difficult to revascularize the reimplanted tooth.
Examine alveolar socket after cleaning it with saline. Do not overlook fracture of tooth and alveolar ridge.
Reimplant the tooth gently with firm finger pressure. Ask the patient to bite down firmly on a piece of gauze to help stabilize the tooth.
After evaluating the occlusion, stabilize the tooth if required. Ideal splint required for an avulsed tooth is a flexible splint. The commonly used flexible splints are made of Gortex, metallic mesh stripes, synthetic clothes or orthodontic wire. A thick strip of composite bonded to the avulsed and the adjacent teeth also act as a splint.
The splint should engage several teeth around the avulsed tooth and it should be kept in place for not more than 7 to 10 days.
Continue with the same treatment as above.
Tooth with open apex:
Clean the root surface with saline.
Examine the alveolar socket after cleaning it with saline.
Cover the root surface with minocycline hydrochloride microspheres before reimplanting to kill bacteria which could enter the immature apex and form an abscess.
Continue with the same treatment as above.
Ref: Textbook of endodontics, Nisha Garg and Amit Garg, 3rd edition, pg no:477
Category:
Dental
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